This cartoon is by me and Becky Hawkins.
Dylan Scott wrote an article on Vox entitled “The One Big Unanswered Question About Ozempic.” Ozempic seems to take away urges, and not only hunger related urges. And no one seems to know what that means yet.
“What are the very long-term effects of these drugs? The literature will say, ‘Well, there isn’t really bad long-term effects because some people have been taking it for diabetes for 10 years, and they don’t have bad effects,’” Kent Berridge, a professor of psychology and neuroscience at the University of Michigan, told me. “And I think that’s a fair argument. But then 10 years is not 20 years or 30 years.”
Maybe twenty years from now, we’ll all agree that Ozempic is great. I’m certainly not advising anyone not to take it; that’s a decision individuals have to make for themselves. But miracle weight loss drugs don’t have the greatest track record.
In the same article, Scott brought up a study which – I’m pretty sure unintentionally – underscores the need for caution.
Research has consistently found that weight loss tends to be more sustainable when it includes behavioral changes in addition to pharmaceutical interventions.
The link goes to a 2005 study in the highly respected New England Journal of Medicine, “Randomized Trial of Lifestyle Modification and Pharmacotherapy for Obesity.”
(Contrary to Dylan Scott’s claim, the study isn’t about “sustainable” weight loss. In fact, it only followed subjects for a year. It’s a study of how effective different weight loss approaches are, not how well they’re sustained.)
They found that pharmaceutical plus “lifestyle modification” (exercise, talking to nutritionists, etc.) led to more weight loss than other approaches – 26 pounds loss, versus 15 pounds for those who only made lifestyle modifications. (Although keep in mind, it’s likely most of the subjects regained the weight in the long run.) The study concluded that “the results underscore the importance of prescribing weight-loss medications” in combination with lifestyle change.
26 pounds – that’s amazing! And this was in 2005! So why isn’t everyone today losing weight taking that miracle pill?
Because the miracle pill in question was sibutramine, also known as Meridia, and it was banned in 2010 because it was causing patients to have heart attacks and strokes.
In 2005, doctors were recommending sibutramine for weight loss. In 2010, after doing no one knows how much damage, sibutramine was banned. And now it’s forgotten. We’ve gone through this cycle a lot.
Horrifyingly, all the treatments mentioned in this cartoon were real historic weight-loss treatments. And honestly, we could have done twice as many panels. Here are some links in case you’d like to read more:
The Seesawing History of Fad Diets
History of Slimming Diets up to the Late 1950s
Fad Diets and Weight Loss: From the 1800s to the 1930s
Deadly Diet Culture Throughout History
Becky writes:
I love drawing a “thingie through the ages” comic. They take a lot more time to research than a comic set in one period, though. I had about 30 tabs open while I was drawing this!
I know that we’ll always see fashion through a present-day lens. For example, someone might see flannel and wide-legged jeans as “90s fashion” instead of “clothes that indicate a high schooler is into grunge music, smoking pot, or is just on stage crew,” which was what that meant in my high school in the 90s.
That said, I have a specific pet peeve: when a period film is thoroughly researched and lovingly presented, everything is authentic and gritty except that the leading lady’s hair and makeup looks Good ™. Dare to make historical characters look a little funny!
The ideal woman has VERY SLOPEY SHOULDERS, okay?
I’m really pleased with the graphics I drew around the captions. I got the idea for them when I saw this old ad and thought that the leafy pattern could nicely fill the space to the right of “1850.”
I realized that every panel was in danger of having dead space at the top, and I thought that different colors, textures, and shapes would be a great way to indicate different eras. The 1912 and 1928 graphics also come from advertisements; the 1970s one just lives in my brain. Barry found this design blog to help with the 1996 graphic. Just seeing those colors and textures brought back vivid memories of notebooks, magazines, and TV commercials!
TRANSCRIPT OF CARTOON
This cartoon has six panels. Each panel has a large caption at top, indicating the date.
PANEL 1 – 1850
Three people in 1850s clothing, two women and a man with a fantastic mustache, sit at a table. A tray in front of them is piled high with wafers.
MAN: Dr Simm’s Arsenic Wafers will safely make you slender and beautiful! Trust me, I’m a doctor!
PANEL 2 – 1912
A doctor in a white lab coat talks to us. He stands with his arm around a gigantic tapeworm, which is about as tall as he is.
DOCTOR: You just swallow tapeworm eggs. These sweet creatures are nature’s path to slimness!
TAPEWORM: What could go wrong?
PANEL 3 – 1928
A man in a tux lights a cigarette for a glamourous woman in a flapper-style dress.
MAN: Light a Lucky Strike and you’ll never miss sweets that make you fat!
PANEL 4 – 1975
A doctor in a white lab coat grins at us as he holds up a pill bottle. Behind him, a beautiful woman sleeps on a bed.
DOCTOR: Sedatives! Sleep twenty hours a day and you won’t be eating! Nothing could be healthier!
PANEL 5 – 1996
A man talks to us while holding up a Time Magazine cover. The cover shows the body of a slim woman in a bathing suit, with the caption “Hot New Diet Pill.”
MAN: It’s called Fen-Phen! What a fun name, right? You’ll lose weight and it definitely probably maybe won’t cause heart attacks!
PANEL 6- TODAY
A doctor holds up a syringe, as he talks to us with a grin.
DOCTOR: Just inject once weekly for the rest of your life and you’ll stop wanting to eat. Totally safe! Trust us, we’re doctors!
CHICKEN FAT WATCH
“Chicken fat” is obsolete cartoonists’ terminology for unimportant but fun details slipped into the art.
PANEL 1: One of the women has died.
PANEL 2: A box on a little table is labeled “WYRM” and has an illustration of a tapeworm framed by laurel branches.
PANEL 3: There are six ashtrays, overflowing with cigarette butts, on a table in the foreground. The entire panel is laid out to resemble a 1920s magazine ad.
PANEL 4: The sleeping woman is dressed like a flower child, and her hair is drawn with spirals, which illustrators did a lot in the 1970s. Outside a window, we can see Merryweather and Maleficent from Sleeping Beauty enjoying eating cake; Maleficent is feeding a bit to her pet raven Diablo.
PANEL 6: The doctor’s necktie has a pattern of cartoon tapeworms.
You know you could have easily made the last panel about vaccines and it wouldn’t have made much difference.
Perhaps I’m a sucker, but I’ve requested and taken both the COVID vaccines and Ozempic, with doctor approval.
I take the point, generally, that people have been suckered and harmed by weight loss schemes in the past, and people driven by a desire to be more attractive tend to be more credulous. Weight loss is the low hanging fruit, but there are obvious other examples – When considering examples, I immediately thought of hair loss and recent studies showing a connection between finasteride and cognitive issues.
But frankly, I think people are sleeping on this.
We know the basic science of how this works, and what it does. This isn’t untested. The protein is naturally produced by people. Some people produce more of it than others, and increasing the amount of that protein in someone’s system to levels naturally produced in other people hits me as being medically on par with taking insulin. The idea that the protein mixed with a transmission solution could have severe adverse reactions is probably more anti-science than a lot of the positions of anti-vaxxers.
Meanwhile…. It does help regulate blood sugar, stave off craving, reduce blood pressure, and produces a whole host of other, measurable, objective benefits. I have no problem with people making their own health decisions, and by all means: read. But just like I’d urge people to get vaccinated, I’d urge people to talk to their doctor about taking a GLP-1. Cardiovascular disease is, by far, the most deadly health complication in America. The number of people who would live longer, healthier lives if everyone were taking a prescribed dose of GLP-1, I think, is profound.
The problem, even in Canada, is pricing and insurance. I pay about $250/month out of pocket because I’m taking it off-label, But were I so inclined and if I trusted myself to keep the process sterile, it’s possible to import the protein from China and mix the solution yourself for about a third of that. I don’t recommend that, it’s too easy to contaminate something, but it highlights that the markup that people are paying is, as usual, disgusting. I can’t wait for the generic, on-label options.
I’m not going to take this stuff unless a doctor tells me “Take this or die” or long-term studies are completed. Which has pretty much been my approach towards the Covid vaccine. I took the first one. I took the first booster. And since then I’ve said “No thanks.”
“But were I so inclined and if I trusted myself to keep the process sterile, it’s possible to import the protein from China, ….”
Keeping the process sterile isn’t nearly as hard as you might think. Buy a pressure cooker; 15 lbs for 15 minutes will sterilize most equipment, skin can be sterilized with ethanol followed by povidone-iodine; after that it’s a matter of technique. But trusting any such product sourced from China without an independent, domestic means of analyzing it? Good God in Heaven, no. Heck, I remember when dogs died all over America of poisoning because a Chinese dog food manufacturer put ground up melamine in the food to spoof American quality control protein assays (which only actually measured the amount of amines in the food, not the amount of amino acids) and enable them to make the dog food more cheaply.
The June 1856 ad:
It has always struck me when I look at that kind of clothing to say “Wasn’t that pretty damn HOT?”